To the 1st Edition
It is with the greatest enthusiasm that I introduce Pocket Medicine. In an era of information glut, it will logically be asked, "Why another manual for medical house officers?" Yet, despite enormous information readily available in any number of textbooks, or at the push of a key on a computer, it is often that the harried house officer is less helped by the description of differential diagnosis and therapies than one would wish.
Pocket Medicine is the joint venture between house staff and faculty expert in a number of medical specialties.This collaboration is designed to provide a rapid but thoughtful initial approach to medical problems seen by house officers with great frequency. Questions that frequently come from faculty to the house staff on rounds, many hours after the initial interaction between patient and doctor, have been anticipated and important pathways for arriving at diagnoses and initiating therapies are presented.This approach will facilitate the evidence-based medicine discussion that will follow the workup of the patient. This well-conceived handbook should enhance the ability of every medical house officer to properly evaluate a patient in a timely fashion and to be stimulated to think of the evidence supporting the diagnosis and the likely outcome of therapeutic intervention. Pocket Medicine will prove to be a worthy addition to medical education and to the care of our patients.
Dennis A. Ausiello, MD Physician-in-Chief, Massachusetts General Hospital Jackson Professor of Clinical Medicine, Harvard Medical School
Written by residents, fellows, and attendings. the mandate for Pocket Medicine was to provide, in a concise a manner as possible, the information a clinician needs to know to approach and manage the most common inpatient medical problems.
The tremendous response to the pevious editions suggests we were able to help fill an important need for clinicians. With this third edition come several major improvements including: a thorough updating of ¿m*. every topic; the addition of several new topics (intracardiac devices, interpretation of CXRs, fungal infections, tick-borne infections, and hypothermia for anoxic brain injury); incorporation of references to the most recent reviews and important studies published through the start of 2007; and the use of color. We welcome any suggestions for further improvement.
¿■h, Of course medicine is far too vast a field to ever summarize in a textbook of any size. Whole textbooks have been devoted to many of the topics discussed herein. Pocket Medicine is meant only as a starting point to guide one during the initial phases of diagnosis and management until one has time to consult more definitive resources. Although the recommendations herein are as evidence-based as possible, medicine is both a science and an art. As always, sound clinical judgment must be applied to every scenario.
I am grateful for the support of the house officers, fellows, and attendings at the Massachusetts General Hospital. It is a privilege to work with such a knowledgeable, dedicated, and compassionate group of physicians. I always look back on my time there as Chief Resident as the best job I have ever had. I am grateful to several outstanding mentors. including Hasan Bazari, Denny Ausiello, Larry Friedman, Nesli Basgoz. Mort Swartz, Eric Isselbacher, Bill Dec, Mike Fifer, Peter Yurchak, and Roman DeSanctis. Special thanks to my parents for their perpetual ^Mks encouragement and love and, of course, to my wife. Jennifer Tseng, who. despite being a surgeon, is my closest advisor, my best friend, and the love of my life.
I hope that you find Pocket Medicine useful throughout the arduous but incredibly rewarding journey of practicing medicine.
Marc S. Sabatine. MD. MPH
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